The kneeling test is a valid method of assessing kneeling tolerance

Area of Science:

• Orthopedics
• Biomedical Engineering
• Rehabilitation Science

Background:

• Quantitative assessment of kneeling tolerance is lacking, hindering pre- and post-surgical evaluation.
• Kneeling is a common functional activity affected by knee conditions and surgeries.

Purpose of the Study:

• To validate a novel kneeling test designed to quantitatively measure kneeling tolerance.
• To assess the test's reliability and validity in various patient populations.

Main Methods:

• 179 participants (324 knees) including asymptomatic, osteoarthritis (OA), total knee arthroplasty (TKA), and anterior cruciate ligament reconstruction (ACLR) groups.
• Kneeling performed on a custom platform at 90° and 110° flexion on varied surfaces, with a 0-100 pain/discomfort score.
• Statistical analysis included mixed models, Pearson's correlation with FJS/WOMAC, and intraclass correlation coefficient (ICC) for reliability.

Main Results:

• The kneeling test showed good discriminative validity, differentiating between asymptomatic knees and those with OA, ACLR, or TKA at both 90° and 110° (p < 0.013).
• Strong correlations were found between the kneeling test and FJS/WOMAC scores, supporting construct validity (e.g., 110° FJS: 0.579, WOMAC: -0.648).
• High test-retest reliability was demonstrated, with ICC values of 0.843 at 90° and 0.926 at 110°.

Conclusions:

• The developed kneeling test is a valid and reliable method for quantitatively assessing kneeling tolerance.
• This tool can assist in evaluating surgical outcomes and guiding modifications to improve patient function and satisfaction.